Even with this week’s Supreme Court ruling that upheld most provisions of the 2010 law, hospitals and health systems around the country will have to continue, if not accelerate, their improvement efforts that started well before the passage of the Patient Protection and Affordable Care Act. These practical changes, driven by proven systems engineering and management principles, often referred to as “Lean thinking,” will continue making care safer and less expensive, regardless of what happens in our nation’s capital.

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“Henry Ford has been a national leader by demonstrating a strong and continued commitment to improving care and reducing costs. Its No Harm Campaign, which started before passage of the Affordable Care Act, has resulted in a 31 percent reduction in harm events and 12 percent reduction in mortality over a three-year period. By comparison, the average reduction in harm events is roughly 1 percent to 2 percent per year in most U.S. hospitals.”

“But transforming the delivery of healthcare will take much more than the strike of a gavel or stroke of a pen,” American Hospital Association President and CEO Richard Umbdenstock said in written statement. “It calls for the entire healthcare community to continue to work together, along with patients and purchasers, to implement better coordinated, high-quality care.”

“As a health care leader I obviously support every American having access to health care insurance,” said Carroll Hospital Center President and CEO John Sernulka. “The way I view it, the original law and now reaffirmation by the Supreme Court is a major catalyst towards recognizing that the health care system in America is too costly and is too fragmented and is not working.”

Some executives also remain skeptical that the influx of paying patients will materialize. “The tax for not having health insurance is so small” that many may choose to go uninsured, said Barry Arbuckle, chief executive of MemorialCare Health System, which runs six Southern California nonprofit hospitals.